Destination Health Info for Travelers

Accidents & Medical Insurance: • Accidents and injuries are the leading cause of death among travelers under the age of 55 and are most often caused by motor vehicle and motorcycle crashes; drownings, aircraft crashes, homicides, and burns are lesser causes.• Heart attacks cause most fatalities in older travelers.• Infections cause only 1% of fatalities in overseas travelers, but, overall, infections are the most common cause of travel-related illness.• MEDICAL INSURANCE: Travelers are advised to obtain, prior to departure, supplemental travel health insurance with specific overseas coverage. The policy should provide for direct payment to the overseas hospital and/or physician at the time of service and include a medical evacuation benefit. The policy should also provide 24-hour hotline access to a multilingual assistance center that can help arrange and monitor delivery of medical care and determine if medevac or air ambulance services are required.

Animal Hazards: Stingrays, poisonous fish, various sharks, sea anemones, corals and jellyfish are hazards to swimmers. Tropical centipedes can inflict painful stings if touched. Common sense is usually adequate to avoid these hazards.

Cholera: This water-borne diarrheal disease occurs sporadically in Oceania. Rare cases of cholera have occurred in this country but there is little, if any, danger to tourists.• Cholera is an extremely rare disease in travelers from developed countries. Cholera vaccine is recommended primarily for people at high risk (e.g., relief workers) who work and live in highly endemic areas under less than adequate sanitary conditions. • The manufacture and availability of the injectable cholera vaccine in the United States ceased in June 2000. • Many countries, including Canada, license an oral cholera vaccine. The oral vaccine is not available in the United States.• Cholera vaccine is not "officially" required for entry into, or exit from, any country. Despite this, some countries, on occasion, require proof of cholera vaccination from travelers coming from cholera-infected countries. Anticipating such a situation, certain travelers may wish to carry a medical exemption letter from their health-care provider. Travel Medicine, Inc., recommends that travelers use the International Certificate of Vaccination (Yellow Card) for this purpose, having their health-care provider state "exempt from cholera vaccine" and validate the exemption with both their signature and their official stamp (the "Uniform Stamp" in the United States).

Dengue Fever: Sporadic cases and out-breaks are reported. Travelers should take protective measures against mosquito bites.

Filariasis: Sporadic cases and outbreaks are reported. Travelers should take protective measures against mosquito bites.

Hepatitis: All nonimmune travelers should receive hepatitis A vaccine. The hepatitis B carrier rate in the general population exceeds 10 percent. Vaccination against hepatitis B should be considered for stays over 3 months and by short-term travelers desiring maximum protection. Travelers should be aware that hepatitis B can be transmitted by unsafe sex and the use of contaminated needles and syringes.

Japanese Encephalitis (JE): Sporadic cases and outbreaks are reported. Travelers should take protective measures against mosquito bites.

Malaria: No risk.

Road Safety: Traffic moves on the left. While roads in Nuku'alofa paved, most other roads are not. Animals & unwary pedestrians walking in road make night driving on unlit secondary roads hazardous.

Ross River Fever: Sporadic cases and outbreaks are reported. Travelers should take protective measures against mosquito bites.

Travelers' Diarrhea: Low to medium risk: The tap water in Nuku’alofa is potable, but travelers are advised to consume only boiled or bottled water unless assured the water has been adequately treated. A quinolone antibiotic, combined with loperamide (Imodium), is recommended for the treatment of diarrhea.

Typhoid Fever: Typhoid vaccine is recommended, especially for long-term travelers, adventure travelers, and those wishing maximum disease protection. Because the typhoid vaccines are only 60% to 70% effective, safe food and drink guidelines should continue to be observed.